Provider Demographics
NPI:1346670494
Name:SANTACLARA, YDANIA (ARNP)
Entity Type:Individual
Prefix:
First Name:YDANIA
Middle Name:
Last Name:SANTACLARA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1956 MARSEILLE DR
Mailing Address - Street 2:APT 8
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33141-3425
Mailing Address - Country:US
Mailing Address - Phone:786-261-8872
Mailing Address - Fax:
Practice Address - Street 1:1956 MARSEILLE DR
Practice Address - Street 2:APT 8
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33141-3425
Practice Address - Country:US
Practice Address - Phone:786-261-8872
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-26
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9339483163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse